A 35-year-old man presents with mediastinal mass, fever, and weight loss. Biopsy shows large binucleate cells with prominent 'owl-eye' nucleoli in a background of eosinophils, plasma cells, and lymphocytes. IHC shows CD15+, CD30+, CD45-. Which subtype of Hodgkin lymphoma is most likely?

• A Nodular sclerosis classical Hodgkin lymphoma ✓
• B Lymphocyte-rich classical Hodgkin lymphoma
• C Mixed cellularity classical Hodgkin lymphoma
• D Lymphocyte-depleted classical Hodgkin lymphoma

Explanation

Nodular sclerosis is the most common subtype of classical Hodgkin lymphoma, predominantly affecting young adults with mediastinal involvement. The Reed-Sternberg cell variant (lacunar cells) and prominent collagen bands are characteristic; the IHC pattern CD15+/CD30+/CD45- confirms classical HL. The mixed-cellularity variant also has a polymorphous background but lacks the collagen bands and mediastinal predilection of nodular sclerosis.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.